Doing gynaecology today

A qualitative study from the area of Basel, Switzerland

Bettina Schwind

In the late 1970s, a feminist health movement spread with the aim to redefine women’s position within society and medicine. So-called women’s health centers’ (WHCs) were established in a number of countries, emphasising self-help approaches and participatory democracy with their services being women-centered: Women caring for women, turning them into subjects of care. The aim was to demystify medical processes and to demedicalise phases of women’s life by empowering women through education, enabling them to take on an active role in medical discussions and decision-making processes (Kolip & Lademann 2010, Kuhlmann & Kolip 2005, Boston Women's Health Collective 1975 & 1970).

This research originally was initiated by the only WHC in Switzerland that outlived its former feminist contemporaries. A medical dissertation piloted the evaluation of the working approach with a focus on patient characteristics exclusively (Zobrist 2005). The ongoing SNF research project WAGE (Women and Gynaecology in Evaluation, SNF Nr. 32003B-121358) takes on an extended approach: It includes six differing gynaecological care settings, ranging from self-declared conventional practitioners to feminist medical experts. Whereas the SNF project applies a mixed methods approach, addressing whether differing working approaches in gynaecology can be characterised and have an impact on patient’s health outcomes, this PhD research focuses on the gynaecologists’ part and uses a qualitative approach exclusively.

Previous studies identified varying patient characteristics between WHCs and traditional care settings, but overall failed to acknowledge their perspectives on care received. Moreover, only little is known on whether differing working approaches across medical care settings and WHCs indeed exist and how these approaches are understood and practiced (Bean-Mayberry 2006, Zobrist 2005, Anderson 2002, Harpole 2000, Phelan 2000, Broom 1998, van den Brink-Muinen 1998, 1997). Even less is known on differences in working approaches concerning feminist care concepts (Kuhlmann & Annadale 2009, Thomas & Zimmermann 2007, Bitzer & Riecher-Rösler 2005, Thomas 2000). Studies also overlooked the area of gynaecology – a former cornerstone of the feminist health movement.

Therefore, this PhD research focuses on how various gynaecological care settings differ in their ways of caring for women, and on how women view and experience care received. The objective is to characterise care settings, displaying how these relate to, differ between but also equal each other, considering such feminist influencing concepts as: women-friendliness, gender orientation, empowerment, de-medicalisation, health orientation, and an active role in decision-making. This PhD research applies a qualitative approximation to the topic, using grounded theory as the method for analysis.

Dieses Buch basiert auf einer Promotion im Fach Public Health/Epidemiologie an der Universität Basel (2016 ) und wurde von Prof. Dr. Elisabeth Zemp Stutz sowie a. o. Prof. Dr. Beate Wimmer-Puchinger (Universität Wien / Universität Salzburg) und Prof. Dr. em. Andrea Maihofer begutachtet.